Frazier L M, Brown J T, Divine G W, Fleming G R, Philips N M, Siegal W C, Khayrallah M A
Duke University Medical Center, Durham, North Carolina.
Ann Intern Med. 1991 Jul 15;115(2):116-21. doi: 10.7326/0003-4819-115-2-116.
To determine whether an educational program featuring a drug cost manual can assist physicians in reducing their patients' out-of-pocket prescription drug expenses.
Prospective controlled trial.
A general internal medicine-teaching clinic in a university hospital.
Fifty-one medical interns.
Thirty-one interns received a manual of comparative drug prices annotated with prescribing advice, two feedback reports, and weekly cost-oriented prescribing reminders. A control group concurrently participated in a manual-based educational program on cholesterol management.
Copies of 3012 prescriptions written over 8 months were analyzed.
Intervention group physicians prescribed less expensive drugs within classes of drugs. The change in drug price score per prescription was -0.15 (95% Cl, -0.27 to -0.04; P = 0.01). A score of 3 was assigned to the most expensive, 2 was assigned to intermediate-priced, and 1 was assigned to the least expensive drug or drugs in the class. An increase of 0.74 months' (Cl, 0.49 to 0.98; P less than 0.001) supply of medication was dispensed per prescription, reducing dispensing fees. The program was well accepted by the physicians.
This relatively simple educational intervention can help physicians to reduce their patients' drug expenses and may serve as a model for incorporating cost information into the routine practice of medicine.
